Mississippi Gov. Phil Bryant (R) doesn't like President Barack Obama's health care reform law. It's too expensive and too intrusive, he says. And Bryant has another reason to oppose the law, he revealed in an interview with Kaiser Health News: It's not necessary because everyone's doing just fine now. There is no one who doesn't have health care in America. No one. Now, they may end up going to the emergency room. There are better ways to deal with people that need health care than this massive new program. If that sounds familiar, it's because this is a common rationale offered by opponents of expanding government programs that provide health care coverage. Bryant and others are referring to a 1986 federal law requiring hospitals that receive Medicare money (i.e., almost all of them) to stabilize and treat anyone who shows up with an emergency medical condition regardless of ability to pay. Republican presidential nominee Mitt Romney repeatedly made such comments during his failed bid to defeat Obama last year. "If someone has a heart attack, they don't sit in their apartment and die. We pick them up in an ambulance and take them to the hospital and give them care," Romney said during an interview on CBS News' "60 Minutes" in September. If, like Bryant and Romney, you believe that no Americans are forced to go without health care because they can't afford it, there's no compelling reason to support expanding coverage to millions of people under President Barack Obama's health care reform law. Would that it were so simple. In 2011, 48.6 million Americans had no health insurance, according to the most recent census data. Among those who do have coverage, many still can't afford medical care so they skip it. The truth is, there's a health care access problem and it's been getting worse. And Mississippi has the fifth-highest rate of uninsured residents in the nation: 19 percent. Funneling uninsured, "underinsured," and poor people to emergency rooms isn't great for the hospitals, either. Hospitals absorbed $41.1 billion in unpaid bills (known in the business as "uncompensated care") in 2011, according to a report issued by the American Hospital Association this month. And unpaid medical bills can haunt patients for years and subject them to brutal debt collections. Community health centers and free clinics don't have the capacity to handle all the patients who need help. Even in Massachusetts, where Romney enacted the model for Obamacare in 2006 and where just 4 percent of people were uninsured in 2011, free clinics still see a lot of patients, WBUR reported Tuesday. The predicament is about to get worse for hospitals in states that don't expand Medicaid under Obamacare. Medicare and Medicaid currently provide extra money to facilities that treat a disproportionate share of patients who can't pay their bills. The health care law makes significant cuts to those funding streams -- because more people are supposed to get private health insurance or Medicaid starting next year. Based on this calculation, the American Hospital Association and other national industry lobbying groups endorsed the health care overhaul. The hospitals in Bryant's home state see things the same way: The Mississippi Hospital Association backs the Medicaid expansion. Not broadening Medicaid would "be devastating," the association said in a statement last June. "Hospitals cannot be expected to treat such a large volume of people with no expectation or prospect of payment for those services. The result could very well mean the closure of many of our community hospitals." Bryant, like other Republican governors, opposes Obamacare's Medicaid expansion for poor people and he wants to stop state Insurance Commissioner Mike Chaney (R) from establishing a health insurance exchange in the state under the law. Instead, Bryant wants the federal government operate the marketplace for Mississippi residents, which is what 25 other states have opted to do.
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